Az orvos-, egészségtudományi- és gyógyszerészképzés tudományos műhelyeinek fejlesztése(EFOP-3.6.3-VEKOP-16-2017-00009)
Támogató: EFOP-VEKOP
EFOP(EFOP-3.6.2-16-2017-00006) Támogató: EFOP
Szakterületek:
Megelőzés
Metaanalízis
Orvos- és egészségtudomány
The quadrivalent human papillomavirus (HPV) vaccine has been assumed to give protection
against genital warts (GW) as well as cervical cancer. Our main question was whether
HPV vaccine has any effects on the prevention of GW reported in randomised controlled
clinical trials (RCTs) and time-trend analyses.This meta-analysis was performed according
to the PRISMA guidelines using the PICO format. We searched in three electronic databases
(PubMed, Embase, Cochrane Trials), and assessed heterogeneity using the Q-test and
I-squared statistics, meta-regression was also performed. Odds ratios (OR) and their
confidence intervals (CI) were calculated. The sensitivity was tested by leave-one-out
method. We evaluated the presence of publication bias using the funnel plot graph
and the Copas selection model. The strength of evidence was assessed using the GRADE
approach.Eight RCTs (per-protocol populations) and eight time-trend ecological studies
were included in this meta-analysis. A significant reduction (pooled OR = 0.03, 95%
CI: 0.01-0.09; I-squared = 53.6%) of GW in young women was recorded in RCTs, and in
time-trend analyses both in young women (pooled OR = 0.36, CI 95% = 0.26-0.51; I-squared
= 98.2%), and in young men (pooled OR = 0.69, 95% CI = 0.61-0.78; I-squared = 92.7%).
In subgroup analysis, a significant reduction of the number of GW events was observed
especially in women under 21 years (pooled OR = 0.33, 95% CI = 0.17-0.63). Leave-one-out
analysis showed that similar results could be obtained after excluding one study,
meta-regression did not show significant difference.Prophylactic, quadrivalent HPV
vaccination can prevent GW in healthy women and men, therefore, it should be included
in routine immunization programme.
